Systemic inflammatory response syndrome and sepsis – epidemiology, differentiation, diagnostics in in clinical practice

Monika Suchomska, Waldemar Halota, Anita Olczak


Bacterial infection is an important factor causing morbidity and mortality in different populations. Every time exacerbation of infectious response (strength, time of symptom severity, time of progression) and whole cascade of inflammatory reaction is dependent on the efficiency of the organism’s homeostasis. In many situations, especially in case of patients with a decrease level of immune system efficiency, we observe very dynamic intensification of infection and inflammation symptoms.
Every time the inflammatory response affect whole body functions and manifests itself in change of biochemical, hematological, and immunological parameters. Those changes are visible specially during systemic inflammatory response. SIRS (systematic inflammatory response syndrome) and sepsis with high levels of incidence and mortality from many years it is a the large diagnostic and therapeutic problem in clinical practice. Annual mortality caused by sepsis which reaches 30 and 50 deaths per 100 000 population, makes it classified as one of a top causes of death among patients under hospital care. Due to its dynamic nature of its course, it is necessary to thoroughly understand its course which may contribute to the search for more effective biochemical and hematological diagnostic markers which will allow to shorten the time of implementation of effective therapy and decrease mortality.
The aim of this study was to present the specifity of a SIRS and sepsis and to show its progression, complications and available tools and methods of its diagnosis in clinical practice.


sepsis; systemic inflammatory response syndrome; SIRS; cytokines; procalcitonin; C-reactive protein

Full Text:



Kübler, A., Adamik, B., Durek, G., Mayzner-Zawadzka, E., Gaszyński, W., Karpel, E., & Duszyńska, W. (2015). Results of the severe sepsis registry in intensive care units in Poland from 2003− 2009. Anaesthesiology intensive therapy, 47(1), 7-13.

Mozer-Lisewska, I., Służewski, W., Prusinowska, J., Mania, A., Kemnitz, P., Kowala-Piaskowska, A., & Macedulski, T. (2008). Kliniczne i laboratoryjne objawy u pacjentów z inwazyjną chorobą meningokokową. Pediatria Polska, 83(3), 259-263.

Jahnz-Różyk, K. Epidemiology of sepsis. Przewodnik Lekarza/Guide for GPs, 11(1), 190-191.

Sands, K. E., Bates, D. W., Lanken, P. N., Graman, P. S., Hibberd, P. L., Kahn, K. L., & Black, E. (1997). Epidemiology of sepsis syndrome in 8 academic medical centers. Jama, 278(3), 234-240.

Casey, L. C., Balk, R. A., Bone, R. C. (1993). Plasma cytokine and endotoxin levels correlate with survival in patients with the sepsis syndrome. Annals of internal medicine, 119(8), 771-778.

Bone, R. C. (1991). Sepsis, the sepsis syndrome, multi-organ failure: a plea for comparable definitions. Annals of internal medicine, 114(4), 332-333.

Hotchkiss, R. S., Karl, I. E. (2003). The pathophysiology and treatment of sepsis. New England Journal of Medicine, 348(2), 138-150.

Sobieraj-Garbiak, I. A., Drożdżyńska, M. (2016). Wybrane zakażenia bakteryjne–nieuniknione zagrożenia zdrowia i życia człowieka. Pomeranian Journal of Life Sciences, 61(1), 99-107.

Hermann, B., Piątkowski, M., Mędrzycka-Dąbrowska, W., Gaworska-Krzemińska, A., & Basiński, A. (2015). Wstrząs septyczny u dzieci—rozpoznawanie i postępowanie we wczesnej fazie. Problemy Pielęgniarstwa, 23(3), 411-416.

Dymicka-Piekarska, V., Wasiluk, A. (2015). Prokalcytonina (PCT), współczesny wskaźnik infekcji i stanów zapalnych. Advances in Hygiene & Experimental Medicine/Postepy Higieny i Medycyny Doswiadczalnej, 69.

Sugimoto, K., Shimizu, N., Matsumura, N., Oki, T., Nose, K., Nishioka, T., & Uemura, H. (2013). Procalcitonin as a useful marker to decide upon intervention for urinary tract infection. Infection and drug resistance, 6, 83.

Fontela, P. S., Lacroix, J. (2016). Procalcitonin: is this the promised biomarker for critically ill patients?. Journal of Pediatric Intensive Care, 5(04), 162-171.

Novotny, A. R., Luppa, P., Rosenberg, R., Schneider, H., Maak, M., Bartels, H., Friess, H. (2009). Procalcitonin can be used for monitoring sepsis in patients with medullary thyroid carcinoma. Thyroid, 19(11), 1287-1289.

Maiese, A., Del Nonno, F., Dell'Aquila, M., Moauro, M., Baiocchini, A., Mastracchio, A., Bolino, G. (2017). Postmortem diagnosis of sepsis: A preliminary immunohistochemical study with an anti-procalcitonin antibody. Legal Medicine, 28, 1-5.

Riedemann NC, Guo RF, Ward PA. The enigma of sepsis. J. Clin. Invest. 112(4), 460–467 (2003).

Martin, G. S. (2012). Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Expert review of anti-infective therapy, 10(6), 701-706.

Abraham, E., Matthay, M. A., Dinarello, C. A., Vincent, J. L., Cohen, J., Opal, S. M., ... & Repine, J. E. (2000). Consensus conference definitions for sepsis, septic shock, acute lung injury, and acute respiratory distress syndrome: time for a reevaluation. Critical care medicine, 28(1), 232-235.

Levy, M. M., Fink, M. P., Marshall, J. C., Abraham, E., Angus, D., Cook, D., ... & Ramsay, G. (2003). 2001 sccm/esicm/accp/ats/sis international sepsis definitions conference. Intensive care medicine, 29(4), 530-538.

Howell, M. D., Talmor, D., Schuetz, P., Hunziker, S., Jones, A. E., & Shapiro, N. I. (2011). Proof of principle: the predisposition, infection, response, organ failure sepsis staging system. Critical care medicine, 39(2), 322-327.

Vincent, J. L., Sakr, Y., Sprung, C. L., Ranieri, V. M., Reinhart, K., Gerlach, H., ... & Payen, D. (2006). Sepsis in European intensive care units: results of the SOAP study. Critical care medicine, 34(2), 344-353.

Martin, G. S., Mannino, D. M., Eaton, S., & Moss, M. (2003). The epidemiology of sepsis in the United States from 1979 through 2000. New England Journal of Medicine, 348(16), 1546-1554.

Dombrovskiy, V. Y., Martin, A. A., Sunderram, J., & Paz, H. L. (2005). Facing the challenge: decreasing case fatality rates in severe sepsis despite increasing hospitalizations. Critical care medicine, 33(11), 2555-2562.

Sundararajan, V., MacIsaac, C. M., Presneill, J. J., Cade, J. F., & Visvanathan, K. (2005). Epidemiology of sepsis in Victoria, Australia. Critical care medicine, 33(1), 71-80.

Dombrovskiy, V. Y., Martin, A. A., Sunderram, J., & Paz, H. L. (2007). Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Critical care medicine, 35(5), 1244-1250.

Danai, P. A., Moss, M., Mannino, D. M., & Martin, G. S. (2006). The epidemiology of sepsis in patients with malignancy. Chest, 129(6), 1432-1440.

Adhikari, N. K., Fowler, R. A., Bhagwanjee, S., & Rubenfeld, G. D. (2010). Critical care and the global burden of critical illness in adults. The Lancet, 376(9749), 1339-1346.

Esper, A. M., Moss, M., Lewis, C. A., Nisbet, R., Mannino, D. M., & Martin, G. S. (2006). The role of infection and comorbidity: Factors that influence disparities in sepsis. Critical care medicine, 34(10), 2576.

Mayr, F. B., Yende, S., Linde-Zwirble, W. T., Peck-Palmer, O. M., Barnato, A. E., Weissfeld, L. A., & Angus, D. C. (2010). Infection rate and acute organ dysfunction risk as explanations for racial differences in severe sepsis. Jama, 303(24), 2495-2503.

Dombrovskiy, V. Y., Martin, A. A., Sunderram, J., & Paz, H. L. (2007). Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: a trend analysis from 1993 to 2003. Critical care medicine, 35(5), 1244-1250.

Parrillo, J. E., Parker, M. M., Natanson, C., Suffredini, A. F., Danner, R. L., Cunnion, R. E., & Ognibene, F. P. (1990). Septic shock in humans: advances in the understanding of pathogenesis, cardiovascular dysfunction, and therapy. Annals of internal medicine, 113(3), 227-242.

Sands, K. E., Bates, D. W., Lanken, P. N., Graman, P. S., Hibberd, P. L., Kahn, K. L., ... & Black, E. (1997). Epidemiology of sepsis syndrome in 8 academic medical centers. Jama, 278(3), 234-240.

Pittet, D., & Wenzel, R. P. (1995). Nosocomial bloodstream infections: secular trends in rates, mortality, and contribution to total hospital deaths. Archives of internal medicine, 155(11), 1177-1184.

Trick, W. E., & Jarvis, W. R. (1998). Epidemiology of nosocomial fungal infection in the 1990s. Revista iberoamericana de micologia, 15, 2-6.

Danai, P. A., Sinha, S., Moss, M., Haber, M. J., & Martin, G. S. (2007). Seasonal variation in the epidemiology of sepsis. Critical care medicine, 35(2), 410-415.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. BMJ 2003;326:41-4.

Lever, A., & Mackenzie, I. (2007). Sepsis: definition, epidemiology, and diagnosis. Bmj, 335(7625), 879-883.

van der Meer, V., Neven, A. K., van den Broek, P. J., & Assendelft, W. J. (2005). Diagnostic value of C reactive protein in infections of the lower respiratory tract: systematic review. Bmj, 331(7507),

Simon, L., Gauvin, F., Amre, D. K., Saint-Louis, P., & Lacroix, J. (2004). Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis. Clinical infectious diseases, 39(2), 206-217.

Tang, B. M., Eslick, G. D., Craig, J. C., & McLean, A. S. (2007). Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. The Lancet infectious diseases, 7(3), 210-217.

Chopin, N., Floccard, B., Sobas, F., Illinger, J., Boselli, E., Benatir, F., ... & Allaouchiche, B. (2006). Activated partial thromboplastin time waveform analysis: a new tool to detect infection?. Critical care medicine, 34(6), 1654-1660.



  • There are currently no refbacks.

Copyright (c) 2019 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:

Journal Language(s): English 

PBN Poland



Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2 Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase


Universal Impact Factor 1.78 for year 2012. (

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski